| NPI | 1518675289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ01430800) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR21860300) |
| Enumeration Date | 2022-11-10 |
| Last Update Date | 2023-04-05 |